OIG Sends an Open Letter to Providers

Inspector General Daniel R. Levinson said in an Open Letter sent to health care providers March 24 that the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) is refining its Self-Disclosure Protocol (SDP).
“We are narrowing the SDP’s scope regarding the physician self-referral law,” Levinson writes.

SDP is used to resolve civil monetary penalty (CMP) liability issues under both the anti-kickback and physician self-referral (Stark) laws.
Levinson writes in the letter, “OIG will no longer accept disclosure of a matter that involves only liability under the physician self-referral law in the absence of a colorable anti-kickback statute violation.” The OIG will continue to accept providers into the SDP in light of anti-kickback misconduct, regardless of whether physician self-referral liability exists.
“Kickbacks pose a serious risk to the integrity of the health care system, and deterring kickbacks remains a high priority for OIG,” writes Levinson.
Going forward, the new minimum settlement amount to resolve kickback-related submissions accepted into the SDP is $50,000.
Although the OIG is narrowing its scope of the SDP, Levinson says this does not mean they are easing enforcement of the physician self-referral law.
Further information about the SDP can be found on the OIG.HHS.gov Web site.

No Responses to “OIG Sends an Open Letter to Providers”

  1. Karen says:

    I think this is one of the best law’s the government should put into effect, however how are they going to enforce it? I know the RAC is coming back into CT and cannot wait for the day. They need to attack the physicians pulling self referrals to others in their practice and sending patients to their own ASC’s to gain a profit. Physician’s don’t need to cheat the government to make money.

  2. Marc says:

    I can’t figure out what the heck the letter is really saying. It looks like the OIG isn’t going to bother to enforce most of the Stark issues because they aren’t cost effective.

  3. Toni says:

    I agree with Marc, what the heck does the letter say…… Is it any wonder why there is so much confusion about governmental programs? Let me get back to my dictionary and finish disecting this letter!

  4. Pawan Arya, MBA, CPC, CPC-H says:

    Simply stated, the letter means that OIG will accept self disclosure under anti-kickback statue only and minimum penalty has been increased to %50,000.
    SDP no longer covers self-referral violations. The offenders will have no recourse under self disclosure protocol and will continue to be prosecuted without recourse to self disclosure and penalty. NO USE OF COMING CLEAN.

  5. Katrina Moultrie, BS,CPC, CFPC says:

    Thank you so much Pawan Arya, MBA, CPC, CPC-H for explaining that in layman’s terms. Your comments made a world of difference!